Coblation Tonsillectomy Versus Blunt Dissectomy Tonsillectomy in Children

Tonsillectomy is one of the most common surgical procedure performed world wide by the ENT Surgeons.Various methods of tonsillectomy have been practiced over the century aimed at reducing or eliminating intraoperative and postoperative morbidity. Coblation tonsillectomy is a recently introduced surgical technique. Tonsillectomy over blunt dissection tonsillectomy in respect of operative time, intraoperative blood loss, postoperative pain, rate of healing of tonsillar fossa and other postoperative complications. This prospective randomized study was done at Maleka Nursing Home, Bogra and Bangladesh ENT Hospital, Dhaka for 36 months from 1st January 2008 to 31December 2010. 200 children were divided into two groups of equal number. In one group, the tonsillectomy performed by Coblation method and in the other group the tonsillectomy Age ranged from 3-12 years with mean age 5.6 in coblation group and 4-14 years with mean age 7.2 in dissection group. Number of male patients were slightly more than female with male female ratio was 3:2 in coblation group and 3.7:2 in dissection group. Operative time and amount of blood loss is significantly reduced in the coblation group (10-25 min, mean 12 min in coblation group, 18-35 min, mean 25 min in dissection group. Tonsillectomy by using coblation have shown less intraoperative bleeding (5ml-100 ml, mean 15 ml compared with 50-230 ml, mean 65 ml in dissection method).During post operative follow-up on day 8, children of coblation group experienced mild to moderate pain with maximum pain on day 2 and no pain on day 8. On the other hand dissection group experienced moderate to severe pain with maximum pain on day 4 and little or no pain on day 8.Children of coblation group returned to normal diet on day 3 and children of dissection group on day 8.On 8th post operative day, coblation group showed smooth healing without any granulation tissue in tonsillar fossa whereas granulation tissue is observed in dissection group. No major complications were noted in any group except one secondary haemorrhage in dissection group. Coblation tonsillectectomy offers less operative time, minimum blood loss, less post operative pain,early return to normal diet and rapid healing of tonsillar fossa. DOI: http://dx.doi.org/10.3329/akmmcj.v4i1.13681 AKMMC J 2013: 4(1): 25-29

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Diode laser versus blunt dissection tonsillectomy

Bangladesh Journal of Otorhinolaryngology ◽

10.3329/bjo.v18i2.11983 ◽

2012 ◽

Vol 18 (2) ◽

pp. 114-118 ◽

Cited By ~ 2

Author(s):

MA Matin ◽

M Alamgir Chowdhury

Keyword(s):

Blood Loss ◽

Diode Laser ◽

Operative Time ◽

Randomized Study ◽

Blunt Dissection ◽

Tonsillar Fossa ◽

Advantages And Disadvantages ◽

Post Operative Pain ◽

Laser Group ◽

Dissection Method

Introduction: Tonsillectomy is the commonest operation performed in Ear, Nose and Throat Department. Various methods of tonsillectomy have been practiced over the century aimed at reducing or eliminating intra-operative and postoperative morbidity.Aim: This prospective study is aimed at evaluation of advantages and disadvantages of laser tonsillectomy over blunt dissection tonsillectomy in respect of operative time, intra-operative blood loss, postoperative pain, rate of healing of tonsillar fossa and other postoperative complications.Method: This prospective randomized study was done for 18 months from April 2010 to September 2011.One hundred patients were divided into two groups of equal number. In one group, the tonsillectomy performed by Diode laser and in the other group the tonsillectomy performed by conventional dissection technique.Results: Age ranged from 5 - 34 years with mean age 15.4 in laser group and 4-35 years with mean age 15.98 in dissection group. Operative time and amount of blood loss is significantly reduced in the laser group (10-25 min, mean 12 min in laser group, 15-45 min, and mean 25 min in dissection group). Tonsillectomy by using laser has shown less intra-operative bleeding (5ml-20 ml, mean 10 ml compared with 45-250 ml, mean 70 ml in dissection method). Patients experienced mild to moderate pain in laser group and moderate to severe pain in dissection group in first 24-48 hours. Pain increased in intensity after 5-6 days in laser group. On 8th post operative day thin to thick white coating is observed with smooth tonsillar fossa in laser group whereas granulation tissue is observed in dissection group.Conclusion: In conclusion laser tonsillectomy has some advantages over dissection method. There is less operative time and intra-operative bleeding and less immediate post operative pain. Disadvantage of laser tonsillectomy is that there is more pain in 5th to 6th post operative period this may be due to thick slough formation. DOI:http://dx.doi.org/10.3329/bjo.v18i2.11983 Bangladesh J Otorhinolaryngol 2012; 18(2): 114-118

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Holmium laser enucleation of the prostate with Virtual Basket mode: faster and better control on bleeding

BMC Urology ◽

10.1186/s12894-021-00797-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Giorgio Bozzini ◽

Matteo Maltagliati ◽

Umberto Besana ◽

Lorenzo Berti ◽

Albert Calori ◽

...

Keyword(s):

Blood Loss ◽

Hospital Stay ◽

Operative Time ◽

Randomized Study ◽

Urine Volume ◽

Holmium Laser ◽

Laser Enucleation ◽

Holmium Laser Enucleation ◽

Irrigation Volume

Abstract Background To compare clinical intra and early postoperative outcomes between conventional Holmium laser enucleation of the prostate (HoLEP) and Holmium laser enucleation of the prostate using the Virtual Basket tool (VB-HoLEP) to treat benign prostatic hyperplasia (BPH). Methods This prospective randomized study enrolled consecutive patients with BPH, who were assigned to undergo either HoLEP (n = 100), or VB-HoLEP (n = 100). All patients were evaluated preoperatively and postoperatively, with particular attention to catheterization time, operative time, blood loss, irrigation volume and hospital stay. We also evaluated the patients at 3 and 6 months after surgery and assessed maximum flow rate (Qmax), postvoid residual urine volume (PVR), the International Prostate Symptom Score (IPSS) and the Quality of Life score (QOLS). Results No significant differences in preoperative parameters between patients in each study arm were found. Compared to HoLEP, VB-HoLEP resulted in less hemoglobin decrease (2.54 vs. 1.12 g/dl, P = 0.03) and reduced operative time (57.33 ± 29.71 vs. 42.99 ± 18.51 min, P = 0.04). HoLEP and VB-HoLEP detrmined similar catheterization time (2.2 vs. 1.9 days, P = 0.45), irrigation volume (33.3 vs. 31.7 l, P = 0.69), and hospital stay (2.8 vs. 2.7 days, P = 0.21). During the 6-month follow-up no significant differences in IPSS, Qmax, PVR, and QOLS were demonstrated. Conclusions HoLEP and VB-HoLEP are both efficient and safe procedures for relieving lower urinary tract symptoms. VB-HoLEP was statistically superior to HoLEP in blood loss and operative time. However, procedures did not differ significantly in catheterization time, hospital stay, and irrigation volume. No significant differences were demonstrated in QOLS, IPSS, Qmax and PVR throughout the 6-month follow-up. Trial Registration: Current Controlled Trials ISRCTN72879639; date of registration: June 25th, 2015. Retrospectively registred.

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Laparoscopic Spleen-Preserving Distal Pancreatectomy (LSPDP) with Preservation of Splenic Vessels: An Inferior-Posterior Approach

Gastroenterology Research and Practice ◽

10.1155/2018/1683719 ◽

2018 ◽

Vol 2018 ◽

pp. 1-7 ◽

Cited By ~ 3

Author(s):

Yong Fei Hua ◽

Dipesh Kumar Yadav ◽

Xueli Bai ◽

Tingbo Liang

Keyword(s):

Blood Loss ◽

Distal Pancreatectomy ◽

Splenic Artery ◽

Posterior Approach ◽

Operative Time ◽

The Other ◽

Intraoperative Blood Loss ◽

Spleen Preserving ◽

Splenic Vessels ◽

Approach Group

Objective. To summarize the operation experience of laparoscopic spleen-preserving distal pancreatectomy (LSPDP) with preservation of splenic vessels by an inferior-posterior dissection of the pancreatic body and evaluate its feasibility. Methods. Patients undergoing LSPDS at Ningbo Li Huili Hospital and Ningbo Li Huili Eastern Hospital from January 2014 to April 2017 were recruited in this study and were analyzed retrospectively. They were divided into two groups based on the surgical approach: the inferior-posterior approach group and the other approach group. We sought to compare outcomes of the two groups. Results. The LSPDP procedure was completed successfully in 49 cases, and 48 patients had their splenic artery and vein preserved, including 26 cases in the inferior-posterior approach group and 22 cases in the other approach group. There were no significant differences between the two groups with respect to age (p=0.18), sex (p=0.56), preoperative diabetes (p=1.00), ASA grading (p=1.00), tumor size (p=0.91), intraoperative blood loss (t=−0.01, p=0.99), hospital stay (t=−0.02, p=0.98), and pancreatic fistula rates (p=1.00). Patients undergoing LSPDP by the inferior-posterior approach had a shorter operative time (t=−4.13, p<0.001) than the other approach group. Conclusions. LSPDS by the inferior-posterior approach associated with shorter operative time is safe and feasible.

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Coblation versus Diode Laser Tonsillectomy in Children: A Randomized Controlled Trial

Bangladesh Journal of Otorhinolaryngology ◽

10.3329/bjo.v23i2.45144 ◽

2020 ◽

Vol 23 (2) ◽

pp. 140-145

Author(s):

MA Matin ◽

MA Sabur ◽

MAK Azad ◽

MN Islam

Keyword(s):

Blood Loss ◽

Diode Laser ◽

Operative Time ◽

Controlled Trial ◽

Sleep Apnoea ◽

Normal Diet ◽

Recurrent Tonsillitis ◽

Soft Diet ◽

Laser Group ◽

Early Returns

Objective: This study aimed to compare the efficacy of diode laser and coblation tonsillectomy in paediatric patients in relation to operative time, amount of blood loss, post operative pain, healing of tonsillar fossa and returns to normal diet. Methods: A total of 200 patients ,100 for coblaton and 100 for diode laser, aged 3-12 years with recurrent tonsillitis with or without snoring and sleep apnoea were recruited. Participants were prospectively randomised to diode laser and coblation tonsillectomy. Operative time and blood loss were recorded. Pain was recorded by VAS or assessed by using analgesic. Results: The operative time were recorded 07-15 minutes,mean 10 minutes in coblation group and 12-20 minutes ,mean 14 minutes in laser group., Blood loss was recorded 0-15 ml mean 8 ml in coblation group and 10-25 ml mean 13.5 ml in diode laser group . However, at post-operative day seven, the diode laser tonsillectomy group had significantly higher pain scores compared with coblationtonsillectomy groups.Coblation group started normal soft diet on day 5 whereas diode laser started on day 8 Conclusion: Coblation tonsillectomy is associated with less operative time and blood loss, early returns to normal diet and less pain score in comparison to Diode laser tonsillectomy Bangladesh J Otorhinolaryngol; October 2017; 23(2): 140-145

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A comparative study between harmonic scalpel hemostasis and conventional hemostasis in total thyroidectomy

International Surgery Journal ◽

10.18203/2349-2902.isj20201372 ◽

2020 ◽

Vol 7 (4) ◽

pp. 954

Author(s):

Waleed Yusif El Sherpiny

Keyword(s):

Blood Loss ◽

Hospital Stay ◽

Thyroid Surgery ◽

Operative Time ◽

Harmonic Scalpel ◽

Randomized Study ◽

Conventional Technique ◽

Endocrine Surgery ◽

Intraoperative Blood Loss ◽

Conventional Thyroidectomy

Background: Thyroidectomy is the most commonly performed procedure in endocrine surgery. Since the thyroid gland is highly vascular, therefore, rapid and absolute hemostasis is extremely required. Conventional thyroidectomy is commonly used with acceptable outcomes, however, it is time‑consuming and resulted in significant intraoperative blood loss with the possible risk of postoperative hemorrhage, injury to parathyroid glands and laryngeal nerves. The advent of focus harmonic devices was encouraging for improving safety, effectiveness, and reduction of operative time, especially in thyroid surgery. Aim of this study: The purpose of this study was to analyze the effectiveness and surgical outcomes of using ultrasonic harmonic scalpel for thyroid surgery compared to conventional techniques.Methods: This was a prospective, randomized study in which 60 patients with various types of goiters presented for thyroidectomy. The patients were divided into two comparable groups. Group A (30 patients) included patients who had focus harmonic thyroidectomy and Group B (30 patients) included patients who underwent conventional thyroidectomy.Results: Focus harmonic thyroidectomy showed a significant reduction in operative time, intraoperative blood loss, volume of postoperative fluid drainage and meantime for hospital stay compared with conventional thyroidectomy. There were no significant differences in the incidence of postoperative hypocalcemia, seroma, hematoma, wound infection and laryngeal nerve injury between both groups.Conclusions: Focus harmonic thyroidectomy was a safe, effective, faster, and appealing alternative to conventional technique since it reduced the operative time, intraoperative blood loss, postoperative drainage and hospital stay with comparable postoperative complications.

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Comparative analysis of conventional cold curettage versus endoscopic assisted coblation adenoidectomy

The Journal of Laryngology & Otology ◽

10.1017/s0022215119000227 ◽

2019 ◽

Vol 133 (4) ◽

pp. 294-299 ◽

Cited By ~ 4

Author(s):

R Bidaye ◽

N Vaid ◽

K Desarda

Keyword(s):

Blood Loss ◽

Operative Time ◽

The Other ◽

Randomised Study ◽

Adenoid Tissue ◽

Post Surgery ◽

Post Operative Pain ◽

Lower Pain ◽

Operation Duration ◽

Residual Tissue

AbstractObjectiveTo compare conventional cold curettage adenoidectomy with endoscopic assisted coblation adenoidectomy in terms of operative time, primary blood loss, post-operative residual tissue and post-operative pain.MethodsThis prospective non-randomised study was carried out on 60 patients aged 5–12 years. One group underwent conventional cold curettage adenoidectomy and the other underwent endoscopic assisted coblation adenoidectomy, with 30 patients per group.ResultsMean operation duration was significantly higher for endoscopic assisted coblation adenoidectomy. Mean blood loss was 44.33 ml in conventional cold curettage adenoidectomy and 32.47 ml in endoscopic assisted coblation adenoidectomy. The pain grade was significantly lower in endoscopic assisted coblation adenoidectomy. Forty per cent of patients who underwent conventional cold curettage adenoidectomy had adenoid tissue post-surgery, while it was completely absent in endoscopic assisted coblation adenoidectomy patients.ConclusionCoblation adenoidectomy has significant advantages over conventional adenoidectomy in terms of reduced blood loss, no post-operative residual tissue and lower pain grade on day 1 after surgery.

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Coblation cryptolysis for treatment of tonsillar stones: a randomized clinical study

The Egyptian Journal of Otolaryngology ◽

10.1186/s43163-021-00106-9 ◽

2021 ◽

Vol 37 (1) ◽

Author(s):

Osama A. Elsayad ◽

Mohammed S. Hussein

Keyword(s):

Operative Time ◽

Randomized Study ◽

Normal Diet ◽

Bipolar Diathermy ◽

Intraoperative Bleeding ◽

Surgical Interventions ◽

Operative Outcomes ◽

Randomized Clinical Study ◽

Dissection Techniques ◽

Cold Dissection

Abstract Background Tonsillectomy is usually indicated in patients with tonsillar stones. It is thought coblation cryptolysis avoids the hazards related to monopolar bipolar diathermy and the regular cold surgical technique. This study compared the peri-operative outcomes in patients with tonsillar stones submitted to coblation cryptolysis, monopolar bipolar dissection, and cold dissection techniques. This randomized study included 105 patients with tonsillar stones. The included patients comprised three groups: GI (n = 35) was subjected to cold dissection, GII (n = 35) was subjected to monopolar bipolar diathermy tonsillectomy, and GIII (n = 35) was subjected to coblation cryptolysis. Outcome parameters included operative time, intraoperative bleeding, consumption of postoperative analgesia, and time to normal food intake. Results GIII patients experienced significantly shorter operative time, less intraoperative bleeding, less consumption of postoperative analgesics, and less time to normal diet when compared with the other two groups. Conclusion Coblation cryptolysis is a safe and effective technique in the management of tonsillar stones. It appears to be superior to other surgical interventions.

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Comparison of Endoscopic-Assisted Adenoidectomy with Conventional Method

Clinical Rhinology An International Journal ◽

10.5005/jp-journals-10013-1077 ◽

2011 ◽

Vol 4 (2) ◽

pp. 75-78 ◽

Cited By ~ 3

Author(s):

Renuka A Bradoo ◽

Rahul R Modi ◽

Anagha A Joshi ◽

Vikas Wahane

Keyword(s):

Blood Loss ◽

Conventional Method ◽

Teaching Hospital ◽

Operative Time ◽

Randomized Study ◽

Tertiary Care ◽

Operative Blood Loss ◽

Left Behind ◽

Adenoid Tissue ◽

Residual Tissue

ABSTRACT Objective To evaluate and compare the efficacy of endoscopic-assisted (EA) adenoidectomy with the conventional adenoidectomy (CA) with an aim to reduce rates of residual adenoid tissue after adenoidectomy. Methods A prospective randomized study involving 32 patients in which 16 underwent EA and 16 underwent CA. The outcomes compared were residual adenoid tissue after 3 months of surgery, operative blood loss, operative time and complications. Setting A tertiary care teaching hospital. Results EA was significantly better in terms of residual tissue left behind as compared to CA (p < 0.05), similar operative blood loss and operative time with no difference in complications. Conclusion EA makes for a safe and efficacious way to do an adenoidectomy which has a significant advantage over CA.

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Outcome of total laparoscopic hysterectomy in relation to the size of the uterus

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20185290 ◽

2018 ◽

Vol 8 (1) ◽

pp. 74 ◽

Cited By ~ 1

Author(s):

Virupakshi Ajjammanavar ◽

Vinodini P. ◽

Jayashree S.

Keyword(s):

Blood Loss ◽

Operative Time ◽

Laparoscopic Hysterectomy ◽

Total Laparoscopic Hysterectomy ◽

P Value ◽

Early Return ◽

Duration Of Surgery ◽

The Mean ◽

Group 2 ◽

Group 1

Background: Laparoscopic hysterectomy is a safe and feasible technique to manage benign uterine pathology as it offers minimal postoperative discomfort; with shorter hospital stay, rapid convalescence and early return to the activities of daily living. However, to date very few studies have been reported on safety and feasibility of total laparoscopic hysterectomy (TLH) in large sized uteri. The present study was planned to evaluate the intra-operative and post-operative parameters in relation to size of the uterus during TLH.Methods: This study was a comparative study. Fifty women with uterine size less than 12 weeks (Group 1) and fifty women with uterine size more than or equal to 12 weeks (Group 2) for whom TLH was planned for benign indications were included in the study. Intra-operative and post-operative parameters like blood loss, duration of surgery, post-operative pain and complications were compared between the two groups. Comparison was done using independent sample t test. A probability (‘p’ value) of less than or equal to 0.05 at 95% confidence interval was considered as statistically significant.Results: The mean age of the patients in both the groups was matched (44.82 years vs. 43.96 years). The mean operative time (48.80±14.12 minutes vs. 77.3±35.11 minutes; p <0.001) and blood loss (40.10±18.25ml vs. 70.6±65.46 ml; p=0.002) were significantly high in Group 2 compared to Group 1. The mean pain scores were similar in both the groups at 6 hours, 24 hours and at the time of discharge. No significant complications were noted in both the groups.Conclusions: TLH is safe, feasible and acceptable for large size uterus (>12 weeks). However, it is associated with longer operative time, and greater amount of blood loss.

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A comparative study of endoscopic assisted curettage adenoidectomy with conventional adenoidectomy

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20182712 ◽

2018 ◽

Vol 4 (4) ◽

pp. 1053

Author(s):

Abhay Kumar ◽

Prabhu Narayan ◽

Prem Narain ◽

Jaypal Singh ◽

Prateek Kumar Porwal ◽

...

Keyword(s):

Blood Loss ◽

Comparative Study ◽

Endoscopic Surgery ◽

Operative Time ◽

The Other ◽

Conventional Surgery ◽

Group A ◽

Grade Ii ◽

Group B ◽

Grade Iii

Background: In ENT adenoidectomy is a commonly performed surgery. It is conventionally done using the curettage method. This present study aims to evaluate endoscopic assisted curettage adenoidectomy as an alternative.Methods: The present study consisted of forty cases requiring adenoidectomy were divided into two groups of twenty each. In Group A adenoidectomy was done by conventional curettage method and in Group B by endoscopic assisted micro-debrider adenoidectomy. The parameters studied between two groups were intra-operative time, intra-operative bleeding and completeness of resection .The study period was from June 2015 to December 2016. Results: The average time taken in Group A (conventional surgery) was 5.30 minutes and in Group B (powered endoscopic surgery) was 12.30 minute. The average blood loss in Group A was 35 ml (range 10–50) as compared to 30 ml in Group B. Nearly 25 % of the patients who underwent endoscopic assisted adenoidectomy had grade II adenoids. About 30% of the patients who underwent conventional adenoidectomy had Grade III adenoids. A total of 10% of the patients developed primary haemorrhage which was more in conventional adenoidectomy (15%) as compared to endoscopic adenoidectomy (5%).Conclusions:Endoscopic assisted microdebrider adenoidectomy was found to be a safe and effective tool for adenoidectomy. Endoscopic adenoidectomy better for completeness of resection, accurate resection under vision. On the other hand, in conventional adenoidectomy operative time and intra-operative bleeding was less.

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